Peter Hoare was until recently Senior Lecturer at the University of
Edinburgh and Consultant Psychiatrist at the Royal Hospital for Sick Children,
Edinburgh, where he had worked for the past 28 years. He read Psychology,
Philosophy and Physiology at the University of Oxford before completing
undergraduate and postgraduate medical training there. He has a longstanding
research interest in neuropsychiatry, publishing extensively on the
psychiatric aspects of childhood epilepsy. More recently, he has been involved
in the clinical trials of the newer pharmacological medications for
attention-deficit hyperactivity disorder.

If you were not a psychiatrist, what would you do?

A difficult one. I originally wanted to become an academic psychologist,
but felt that the world of maze learning by rats was too remote from the real
life. On a fantasy level, I’d liked to have been an architect, designing
something permanent and beautiful, a Frank Gehry manqué.

What has been the greatest impact of your profession on you
personally?

Seeing patients. I was, and am, still amazed at the willingness of children
and their parents to reveal the intimate details about their personal lives in
such a trusting manner. It’s a privilege to hear their life stories and
something we must treat with the utmost respect. A major clinical dilemma
working with the parents of disturbed children is to avoid being judgemental
about their behaviour, while at the same time enabling them to see their
child’s behaviour from a different perspective.

What are your interests outside of work?

My three loves are supporting Liverpool Football Club, reading biographies
and going to the opera. I have been fortunate enough to visit many opera
houses throughout the world, but my most amazing experience was going to the
Wagner Opera Festival at Bayreuth in 2007. How Wagner could write such sublime
music, yet behave in such a dysfunctional manner in everyday life? A
psychiatric conundrum!

Who was your most influential trainer, and why?

Working for Professor David Taylor as a registrar at the Park Hospital in
Oxford. Supervision consisted of endless unresolved disputes about the
brainlessness or mindlessness of psychiatry, long before Leon Eisenberg coined
the phrase. An exchange of a small cigar usually terminated the
session.⇓

What job gave you the most useful training experience?

As a research fellow in the Oxford University Department of Psychiatry with
Michael Gelder. He gave me complete freedom to explore all avenues, but at a
price – I had to produce a research degree. I always remember his sage
advice about thesis writing: it’s like a filter funnel, start wide and
then narrow down.

Which publication has influenced you most?

Professionally, Michael Rutter’s Isle of Wight study. It showed me
that research in child psychiatry was possible and that it could be
scientific. Personally, undoubtedly Marcel Proust’s A La Recherche
du Temps Perdu. In the 1980s, I had the good or ill fortune to teach
child psychiatry on a post-graduate paediatric course in Riyadh, Saudi Arabia,
each year. Other than teaching, there was little else to do except read and
admire the sand. So each year I would take a couple of volumes and read them
from cover to cover. The psychological and social insights in Proust’s
writing are phenomenal, enriching my own understanding of people
profoundly.

How has the political environment influenced your work?

Despite their protestations, politicians continue to undervalue the
importance of childhood for the well-being of society. They do not accept
William Wordsworth’s aphorism that ‘the child is father to the
man’, so that one has had a perennial struggle to keep children’s
psychological needs on the political agenda.

What part of your work gives you the most satisfaction?

Helping children and families on the rocky road that’s life.

What do you least enjoy?

The innumerable meetings that have no executive authority. The paralysis in
decision-making has a long-term demoralising impact on all health
professionals - it’s not so much that there are too many chiefs, but
rather there’s no chief at all!

What is the most important advice you could offer to a new
trainee?

Work hard, study hard and enjoy yourself. Find a speciality that stimulates
your intellectual curiosity as well as one that suits your personality and
outlook on life. See as many patients as you can – the more you see, the
more you learn.

Do you think psychiatry is brainless or mindless?

A non-question. Psychiatry has the virtue and the vice of combining the
physical and the psychological. I strongly believe that there’s no such
entity as a schizophrenic, but rather there’s a person with
schizophrenia. We must see the person in the disorder, not just the disorder
itself.

What single area of psychiatric practice is most in need of
development?

I know I would say this, but the importance of child development for the
child and for the future adult is still not given the recognition it deserves.
How can you understand the adult without understanding the child? I always
think it’s ironic that on most teaching courses for trainees, child
psychiatry almost invariably comes at the end rather than the beginning.

What single area of psychiatric research should be given
priority?

The childhood precursors of major adult disorders. In the 1990s, I was
involved in an epidemiological survey of all child psychiatry out-patients
throughout Scotland. I’d love to find out what has happened to the 18
000 participants of the original study.

How would you like to be remembered?

This is the sort of question that the late Anthony Clare would have asked
in his ‘In the Psychiatrist’s Chair’series. I’m always
struck how former colleagues rapidly fade from the memories of the
present-tempus fugit! This is inevitable, but rather chastening. I would like
to answer the question by saying that I hope that I had fulfilled some maxims
in Rudyard Kipling’s poem If: ‘If you can meet with
triumph and disaster and treat those impostors just the same...’,
etc.